The Pentagon's HIV/AIDS Programmes: Governmentality, Political Economy, Security

Abstract

This article brings together governmentality and political economic readings of security to offer a critical examination of the international HIV/AIDS programmes operated by the US Department of Defense, particularly as they focus on populations in Africa. Reaching groups often left out of national HIV/AIDS strategies and conducting research into HIV vaccines, US military HIV/AIDS programmes can be read as supportive of the broader global health effort to secure populations from HIV. However, a consideration of publicly available material shows that growing US commitment to addressing the problem of HIV/AIDS parallels, and in the case of military programmes intersects with, the idea of Africa as a locus of strategic resources, fragile states and potential terrorist threats. These ideas are furthermore articulated in terms of a neoliberal teleology, in which health programmes appear as part of an effort to help populations along the path to normal, healthy development, occluding the exploitative manner in which populations and regions highly affected by HIV have been incorporated into the global political economy. Such rationalities are problematic in that they obviate a more substantive grounding of health in ideas of peace or equity and thus provide a poor guide to a more healthy global order. While noting the contribution of US military programmes to the international response to HIV/AIDS, the article emphasises the importance of examining associations between HIV/AIDS, military forces and security in terms of the broader web of rationalities and relationships within which they are situated.

Notes

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32. See for example, W. Anderson, Colonial Pathologies: American Tropical Medicine, Race, and Hygiene in the Philippines (London: Duke University Press 2006).

33. US Department of Defense, Quadrennial Defense Review Report 2006 (Washington, DC: DoD 2006) p. 24; US Department of Defense, Quadrennial Defense Review Report 2010 (Washington, DC: DoD 2010) p. 7; US National Intelligence Council, The Global Infectious Disease Threat and its Implications for the United States (Washington, DC: NIC 2001).

34. Armed Forces Health Surveillance Center, ‘Global Emerging Infections Surveillance and Response System (GEIS) Operations’, available at <http://afhsc.mil/geisPartners>, accessed 3 March 2010. See also the list of DoD contributions to disease control in J. K. Sagala, ‘HIV/AIDS Prevention Strategies in the Armed Forces in Sub-Saharan Africa: A Critical Review’, Armed Forces and Society 34/2 (2008).

35. D. Tarantino, ‘US Military Health System Role in Stability Operations’, presentation at <http://fhpr.osd.mil/intlhealth/pdfs/TarantinoUSAPresentationEnglish.ppt>, accessed 16 April 2010.

36. Force Health Protection and Readiness, ‘Helping Achieve International Health Stability’, <http://fhpr.osd.mil/intlhealth/>, accessed 19 Feb. 2010.

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41. V. K. Nguyen, ‘Government-by-Exception: Enrolment and Experimentality in Mass HIV Treatment Programmes in Africa’, Social Theory and Health 7/3 (2009) p. 211.

42. Military HIV Research Program, ‘Background’, available at <http://www.hivresearch.org/about/background.html>, accessed 19 Feb. 2010.

43. Ibid.

44. S. Rerks-Ngarm, P. Pitisuttithum, S. Nitayaphan, J. Kaewkungwal, J. Chiu, R. Paris, N. Premsri, et al., ‘Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand’, New England Journal of Medicine 361/23 (2009). The significance of the findings was subsequently qualified and the researchers stated that the vaccine would not work in populations with high rates of HIV infection. M. McGrath, ‘HIV Vaccine Trial Was Significant’, available at <http://news.bbc.co.uk/1/hi/health/8315002.stm>, accessed 16 April 2010.

45. DoD HIV/AIDS Prevention Program, available at <http://www.med.navy.mil/sites/nhrc/dhapp/Pages/default.aspx>, accessed 16 April 2010.

46. A. Ingram, ‘Governmentality and Security in the US President's Emergency Plan for AIDS Relief (PEPFAR)’, Geoforum 41/4 (2010) pp. 607–616.

47. DoD HIV/AIDS Prevention Program (note 45).

48. Military HIV Research Program, ‘About’, available at <http://www.hivresearch.org/about/index.html>, accessed 19 Feb. 2010.

49. DoD HIV/AIDS Prevention Program, Winning Battles in the War Against HIV/AIDS: 2008 Annual Report (San Diego: DHAPP, March 2009) p. 16.

50. S. Patrick and K. Brown, The Pentagon and Global Development: Making Sense of the DoD's Expanding Role CGD Working Paper 131 (Washington, DC: Center for Global Development, Nov. 2007). Figures from Office of the Global AIDS Coordinator, ‘The Emergency Plan for AIDS Relief: Summary Financial Status as of December 31, 2008 (1^st Quarter – FY2009) Data for FY2004–2008 Appropriations’, available at <http://www.pepfar.gov/>, accessed 19 Feb. 2010.

51. The DoD has also been allocated over $12 million to work with the Vietnamese military. Figures extracted from PEPFAR Operational Plans FY2004–2008, available at <http://www.pepfar.gov/>, accessed 25 March 2008.

52. Figures from DoD HIV/AIDS Prevention Program, Winning Battles (note 49); excludes Sudan and Niger, for which no estimate of size of military forces was given.

53. Department of Defense Directive 6485.02E (7 Nov. 2006).

54. DoD HIV/AIDS Prevention Program, ‘Resource Support for Selected Non-US Militaries’, available at <http://www.med.navy.mil/sites/nhrc/dhapp/background/Pages/ResourceSupportforSelectedNon-USMilitaries.aspx>, accessed 16 April 2010.

55. AFRICOM, ‘Civil-Military Health Assistance Programs’, streaming video available at <http://www.africom.mil/mmVidGal/mmGallery.asp>, accessed 11 March 2010.

56. M. Shanahan and D. Francis, ‘US Support to African Capacity for Peace Operations: The ACOTA Program’ (Feb. 2005), available at <http://www.stimson.org/fopo/pdf/ACOTA_BriefFinal_Feb05.pdf>, accessed 20 Feb. 2010. Other programmes include Theater Security Cooperation; International Military Education and Training; information operations under Operation Objective Voice; Foreign Military Financing; Foreign Military Sales; Global Peace Operations Initiative; Mil-to-Mil Contact programme; and the National Guard State Partnership Program.

57. D. Volman, ‘Obama's National Security Policy Towards Africa: The First Year’, available at <http://www.pambazuka.org/en/category/features/61614>, accessed 4 March 2010.

58. Commander US Naval Forces Africa, ‘About APS’, available at <http://www.c6f.navy.mil/about%20us.html>, accessed 4 March 2010.

59. US Africa Command, ‘Questions and Answers About ARICOM’, available at <http://www.africom.mil/africomFAQs.asp>, accessed 20 Feb. 2010.

60. See Africa Against AFRICOM, available at <http://africaagainstafricom.org/>, accessed 17 April 2010; Resist AFRICOM, available at <http://salsa.democracyinaction.org/o/1552/t/5717/signUp.jsp?key=3094>, accessed 17 April 2010.

61. J. Keenan, ‘US Militarization in Africa: What Anthropologists Should Know About AFRICOM’, Anthropology Today 24/5 (2008).

62. US Africa Command, 2009 Posture Statement (Stuttgart: US Africa Command 2009) p. 5.

63. Video, ‘The promise of AFRICOM’, available at <http://www.africom.mil/mmVidGal/mmGallery.asp>, accessed 1 March 2010.

64. Ibid.

65. US Africa Command, 2009 Posture Statement (note 62) p. 1, emphasis in original.

66. W. Ward, Commander's Intent 2010 (Stuttgart: US Africa Command 2010) p. 1.

67. US Africa Command, 2009 Posture Statement (note 62) p. 1.

68. US Africa Command, 2009 Posture Statement (note 62) p. 16.

69. DoD HIV/AIDS Prevention Program, ‘Introductory Video’, available at <http://www.med.navy.mil/sites/nhrc/dhapp/Pages/Video.aspx>, accessed 17 April 2010.

70. Center for Strategic and International Studies, ‘US Military Health Programs in Africa’, Seminar Transcript (23 Sep. 2008) p. 22, available at <http://www.kaisernetwork.org/health_cast/uploaded_files/092308_csis_military_transcript.pdf>, accessed 17 April 2010.

71. Foucault, Security, Territory, Population (note 6) p. 105.

72. The term ‘market foster care’ comes from M. Sparke, ‘Unpacking Economism and Remapping the Terrain of Global Health’, available at <http://www.faculty.washington.edu/sparke/>, accessed 17 April 2010.